Whole of government and whole of society approaches: call for further research to improve population health and health equity

• Published in: BMJ global health 2022-07, Vol.7 (7), p.e009972
• Main Authors: Ortenzi, Flaminia, Marten, Robert, Valentine, Nicole B, Kwamie, Aku, Rasanathan, Kumanan
• Format: Article
• Language: English
• Subjects: Accountability; Civil society; Collaboration; COVID-19; Decision making; Editorial; Health disparities; Health policy; Information sharing; International organizations; Maternal & child health; Mental health; Pandemics; Politics; Public Health
• ISSN: 2059-7908; 2059-7908
• DOI: 10.1136/bmjgh-2022-009972

WoG is defined as an approach ‘in which public service agencies work across portfolio boundaries’ to develop integrated policies and programmes towards the achievement of shared or complementary, interdependent goals.10 WoS represents a broader approach, moving beyond public authorities and engaging ‘all relevant stakeholders, including individuals, families and communities, intergovernmental organizations, religious institutions, civil society, academia, the media, voluntary associations and […] the private sector and industry’.10 These terms are also used interchangeably without rigid demarcation, and it is contestable whether they truly have greater or differing specificity as compared with ‘multisectoral’, ‘intersectoral’ or ‘cross-sectoral’. [...]to address the multidimensional and transdisciplinary challenges inherent to the SDH, there is the technical need to overcome departmentalism and siloed work, to increase policy coherence and effectiveness.9 10 The concept of intersectoral action has the longest history within the field of public health, but the terms WoG, WoS and multisectoral action have long been mentioned in public administration and have increasingly been applied to health under the banner of HiAP. Other limitations are difficulties in measuring outcomes and impact of multisectoral efforts and the limited understanding of the role of power dynamics.14 15 The literature that does exist on explicitly labelled WoG and WoS approaches to health is largely dominated by a focus on high-income countries (HICs) and upper-income and middle-income countries. Evidence on WoG strategies in Latin America suggests that health policy has played a marginal role.19 Available (though perhaps outdated) literature from Africa shows that the adoption of WoG and WoS strategies has been restricted to specific priority areas, especially communicable diseases, malnutrition and mental health.20 Reasons for the limited implementation of these approaches in LMICs include lack of capacities and skills essential to cross-sectoral collaboration (eg, negotiation, partnerships and communication); lack of incentives to work across sectors; resources mostly allocated to vertical programmes; administrative challenges such as limited institutional infrastructure (often highly hierarchical); lack of strong accountability systems; political instability and weak leadership.4 19–21 WoG and WoS approaches to health (including when framed under the umbrella of OneHealth22) are int